10 comments:

Not mentioned? Read between the lines. We can only hope for some spine stiffening in the Senate. You also neglected to recognize that this bill passed with bipartisan support. There was one GOP vote in favor. www.MDWhistleblower.blogspot.com

Hey, the person who added the bold for the beginning of each group failed to do so for the doctor section. Look closely, they are mentioned after small employers and before hospitals. Here's what the WSJ blog says re: doctors.

"Doctors: Primary-care doctors could see a strain from an influx of the newly insured. While the bill carries new incentives to boost the supply of these doctors, health professionals expect demand to outpace the supply.

The bill's provisions on medical liability are far short of what most doctors want. It creates new incentive payments to states that have alternative medical liability laws aimed at cracking down on frivolous malpractice lawsuits. Also, the bill doesn't address a looming sharp cut in payments to doctors under Medicare."

Doctors are mentioned. It appears that the formatting left off the bold:

Doctors: Primary-care doctors could see a strain from an influx of the newly insured. While the bill carries new incentives to boost the supply of these doctors, health professionals expect demand to outpace the supply.

The bill's provisions on medical liability are far short of what most doctors want. It creates new incentive payments to states that have alternative medical liability laws aimed at cracking down on frivolous malpractice lawsuits. Also, the bill doesn't address a looming sharp cut in payments to doctors under Medicare.

Lisa, with regard to tort reform, the House bill is absurd. First, states have an incentive to puruse tort reform, but are prohibited from using caps on non-economic damages or lowering attorneys' fees. What's left. In addition, any state (like mine) that enacted tort reform is ineligible for the bill's incentive. www.MDWhistleblower.blogspot.com

Physicians are represented - by their lobbyist, the AMA. If you don't like your lobbyist, then you need to get a new one. That's how it works in the government.

You guys want to run to the govt. for liability protection, but you want to run away from it everywhere else. That's not how it works in Congress. You can't dip your toe in that water just a little bit. And really, you've been swimming in it for a long time, in large part due to your own choices as a profession.

To understand how the current system works against patients, I can give you an example of what happened last night.

A patient who lives 90-minutes away from the doc office she's been seeing has sudden, severe pelvic pain and goes to her local emergency room.

During the exam, she notes that she may be pregnant, so doc calls in GYN on-call who does a vaginal ultrasound and finds two heart beats...in a classic heterotopic pregnancy with one normal implantation in the uterus and one ectopic pregnancy in the tube.

So what does doc do? Sends her home with a referral to a local doc.

Why?

I'll tell you why - liability, that's why! He doesn't want to take the risk to take her to surgery to remove the ectopic while attempting to save the normal pregnancy. Instead, he'll send her home, toss some pain pills her way, and hope and pray she doesn't rupture the tube before referral doc sees her. He hands her off to reduce his own risk and puts her at risk.

Turns out referral doc can't see her until December, tells her to wait it out and if the pain gets worse, call for a referral back to the ER.

So instead of doing that, she calls doc 90-minutes away last night, it's 6:00pm and the office is just getting ready to close up shop for the night. 90-minute away doc asks if she can come in now, she says yes, and he waits while she drives up - almost two hours later, he scans her, confirms the heterotopic pregnancy and gets her scheduled into surgery for this morning as an add-on to his already booked schedule.

Why? Because a rupture can kill her and will certainly destroy the pregnancy in the uterus, which has potential to be saved if she goes into surgery now, not after the fact of a ruptured tube.

90-minute doc was livid last night, not only because ER doc and wussy GYN doc handed her off without even calling him, her physician of record for the pregnancy, but also because he knows why they didn't want to take the risk - her insurance sucks - what they'll be paid is "too low" for the risk involved in the surgery, so rather than do the right thing, they wussed out and punted her, like a football and said a hail mary.

About Me

Westby G. Fisher, MD, FACC is a board certified internist, cardiologist, and cardiac electrophysiologist (doctor specializing in heart rhythm disorders) practicing at NorthShore University HealthSystem in Evanston, IL, USA and is a Clinical Associate Professor of Medicine at University of Chicago's Pritzker School of Medicine. He entered the blog-o-sphere in November, 2005.
DISCLAIMER: The opinions expressed in this blog are strictly the those of the author(s) and should not be construed as the opinion(s) or policy(ies) of NorthShore University HealthSystem, nor recommendations for your care or anyone else's. Please seek professional guidance instead.